The Right Approach To Manage Endometriosis

Living with endometriosis can be a daily battle, from dealing with intense pain to managing social and work-life disruptions. While conditions like PCOS don’t directly cause endometriosis, both often coexist and share challenges that impact physical, emotional, and mental health.

However, when healthcare providers overlook these complexities and focus on weight shaming, patients are less likely to seek help, worsening their condition.

Here’s how one can look into managing endometriosis, its relationship with PCOS, and how a compassionate healthcare approach can make a difference.

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, causing pain and other symptoms. According to Dr Anuradha Kapur, Principal Director (Obstetrics & Gynecology) & Head of Unit at Max Smart Super Speciality Hospital, Saket, symptoms can vary widely: “Many experience painful periods, pain during intercourse, bloating, and fatigue. Others may have irregular bleeding, pain during bowel movements, and even asymptomatic cases,” she notes. Endometriosis is complex and can be difficult to diagnose, especially in asymptomatic cases or when symptoms overlap with other conditions like PCOS.

Endometriosis can disrupt daily routines, impacting work and relationships due to fatigue and persistent pain. Dr Sonam Simpatwar, a reproductive medicine specialist at Central Railway Hospital, Byculla, Mumbai, highlights the importance of staying alert to symptoms, especially for those with risk factors like family history or high estrogen levels. “Symptoms can be subtle, and many women may not experience severe signs until they face issues like infertility,” she explains.

For some, managing endometriosis involves lifestyle changes, pain management, and treatments ranging from hormonal therapies to surgical options. Regular gynaecological check-ups are crucial for catching signs early and avoiding long-term complications.

PCOS, or Polycystic Ovary Syndrome, is often confused with endometriosis due to some overlapping symptoms like irregular periods.

However, as Dr. Kapur explains, “PCOS doesn’t cause endometriosis. They are distinct conditions with different causes—PCOS results from hormonal imbalances, while endometriosis involves abnormal tissue growth outside the uterus.”

Although they don’t directly cause one another, patients with both conditions face unique challenges, including a higher risk of infertility, irregular cycles, and persistent pain.

Managing PCOS can be equally challenging, particularly because it’s closely tied to insulin resistance and weight. Lifestyle changes, such as a balanced diet and regular exercise, are often recommended, but these suggestions can sometimes become oversimplified, leaving patients feeling body-shamed or unsupported.

Many patients with PCOS and endometriosis express discomfort in seeking medical help due to a tendency among some doctors to focus heavily on weight, often without offering practical support. Patients report feeling judged or dismissed, leading many to avoid seeking the care they need.

Dr Kapur highlights that while “weight can impact insulin resistance and hormone levels in PCOS, it’s crucial for doctors to adopt an empathetic approach.” This approach means understanding the complexities of the condition rather than simply prescribing weight loss.

For instance, doctors might shift the conversation from weight alone to include lifestyle guidance that patients can realistically adopt. Suggesting a referral to a nutritionist or creating a structured plan can be more supportive, focusing on the patient’s overall health and making them feel seen beyond their weight.

According to Dr Simpatwar, “PCOS already carries mental and emotional burdens, and weight shaming only exacerbates feelings of isolation.” Such experiences can discourage individuals from seeking the medical attention they need, creating a barrier to effective care.

A supportive doctor-patient relationship can be transformational in managing PCOS and endometriosis effectively. Dr Simpatwar suggests, “Doctors should focus on creating an open dialogue, discussing how diet and exercise can positively impact symptoms without emphasizing weight as the only solution.”

When patients feel heard and understood, they’re more likely to actively engage in their health journey. Here are some ways doctors can offer compassionate support:

Focus on Health, Not Just Weight: Emphasising improved energy levels and reduced symptoms over numbers on a scale can help patients feel more positive and proactive.

Personalised, Empathetic Language: Instead of “You need to lose weight,” language like, “Let’s work together on symptom management through small, realistic changes” feels more encouraging.

Holistic Approaches and Counseling Referrals: Some patients benefit from mental health support due to the emotional toll of chronic pain and hormonal changes, which many patients appreciate when offered.

While every individual’s experience is unique, there are practical strategies to manage life with endometriosis and PCOS that focus on overall well-being rather than just weight.

Focus on Diet and Nutrition: Incorporate anti-inflammatory foods, like leafy greens and fatty fish, and reduce refined sugars. A balanced, low-GI diet can aid with insulin resistance and improve energy levels.

Exercise Regularly for Symptom Relief: Low-impact exercises like yoga, swimming, and walking can help alleviate pain and reduce stress, benefiting both endometriosis and PCOS symptoms.

Build a Support Network: Connecting with others who have similar experiences can provide emotional relief and motivation, helping you feel less isolated.

Communicate Openly with Healthcare Providers: Finding a healthcare provider who listens and validates your concerns can make a big difference. If you feel unheard, don’t hesitate to seek a second opinion.

Consider Hormonal and Non-Hormonal Treatments: Options like hormonal therapy or alternative birth control can manage symptoms; consult your doctor to find what works best for you.